Saposin C pharmaceutical compositions and methods of treating cancer

ABSTRACT

Disclosed are pharmaceutical compositions containing saposin C and phosphatidylserine that are useful for treating various cancers.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.62/647,058, filed on Mar. 23, 2018, and U.S. Provisional Application No.62/678,668, filed on May 31, 2018.

STATEMENT REGARDING GOVERNMENT-FUNDED RESEARCH

This invention was made with Federal government support under contractNos. 2R44CA136017-02A1, 5R44CA136017-03, and 2R44CA136017-04, awarded bythe National Institutes of Health. The Federal government has certainrights in the invention.

This invention was made with an award from the Kentucky Cabinet forEconomic Development, Department of Commercialization and Innovation,under Grant Agreement KSTC-184-512-11-100 with the Kentucky Science andTechnology Corporation.

FIELD OF THE INVENTION

The present invention relates to compositions containing saposin C andmethods of using them to treat various cancer conditions.

BACKGROUND

Saposins, a family of small (˜80 amino acids) heat stable glycoproteins,are essential for the in vivo hydrolytic activity of several lysosomalenzymes in the catabolic pathway of glycosphingolipids. Saposins A, B,C, and D are described in U.S. Pat. Nos. 7,834,147 and 9,271,932.

Nanovesicles comprising saposin C (“SapC”) and dioleoylphosphatidylserine (DOPS) have high affinity for phosphatidylserine-richmembranes in vitro and in vivo, and can induce apoptosis and/necrosis intarget cells (Qi et al. (2009), Clin Cancer Res 2009; 15: 5840-5851).The proposed mechanism by which the SapC-DOPS nanovesicles induceapoptosis is via ceramide elevation through activation of β-glucosidaseand acid sphingomyelinase (with subsequent degradation ofglucosylceramide and sphingomyelin, respectively), which leads toactivation of caspases. The nanovesicle preparation was found to beefficacious against a wide variety of tumor types in vitro and inorthotopic murine tumor models (Qi et al. (2009); Wojton et al. (2013),Mol Ther, 21: 1517-1525; Abu-Baker et al. (2012), J Cancer Ther, 3:321-326; Chu et al. (2013), PLoS One; 8: e75507; U.S. Pat. No.7,834,147).

SUMMARY

This disclosure pertains to aqueous and solid compositions comprisingsaposin C and methods of using such compositions in the treatment ofcancer.

A composition is described that includes: a polypeptide including theamino acid sequence of SEQ ID NO: 1 with zero to four amino acidinsertions, substitutions, or deletions; a phosphatidylserine lipid; abuffer at pH 5.0 to 8.0; trehalose at 1.5 to 9 percent w/w; t-butylalcohol at 0 to 35 percent; and water. The polypeptide is at aconcentration of 0.4 to 5.0 mg/ml, and the molar ratio of thephosphatidylserine lipid to the polypeptide is in the range of 8:1 to20:1. In some embodiments, the buffer is tris(hydroxymethyl)aminomethane(Tris) at a concentration of 10 to 50 mM, and the pH of the compositionis pH 6.8 to 7.6. In some embodiments, the buffer is citrate buffer at aconcentration of 10 to 50 mM. In some embodiments, the buffer is acetatebuffer at a concentration of 10 to 50 mM. In certain embodiments, thephosphatidylserine lipid comprises one or more of dioleoylphosphatidylserine (DOPS), dihexanoyl phosphatidylserine lipid,dioctanoyl phosphatidylserine lipid, didecanoyl phosphatidylserinelipid, dilauroyl phosphatidylserine lipid, dimyristoylphosphatidylserine lipid, dipalmitoyl phosphatidylserine lipid,palmitoyl-oleoyl phosphatidylserine lipid, 1-stearoyl-2-oleoylphosphatidylserine lipid, or diphytanoyl phosphatidylserine lipid. Thephosphatidylserine lipid is preferably DOPS, which may be in the form ofa salt such as a sodium salt. In various cases, the polypeptide includesor consists of amino acid sequence of SEQ ID NO: 1 or the sequence ofSEQ ID NO:1 with one or two amino acid insertions, substitutions, ordeletions. In a preferred embodiment, the composition includes: apolypeptide including the amino acid sequence of SEQ ID NO: 1, at aconcentration of 1.9 to 2.5 mg/ml; DOPS at a concentration of 2.0 to 2.8mg/ml; Tris at a concentration of 23 to 27 mM; trehalose at aconcentration of 4 to 6 percent w/w; and t-butyl alcohol at aconcentration of about 15 to 25 percent w/w; with pH in the range of pH6.8 to 7.6.

Also described is a composition in solid form, e.g., a lyophilizedpowder composition, that includes: a polypeptide including the aminoacid sequence of SEQ ID NO: 1 with zero to four amino acid insertions,substitutions, or deletions; a phosphatidylserine lipid; a buffer; andtrehalose at 75 to 90 percent w/w. The polypeptide in this compositionis at a concentration of 3.2 to 4.4 percent w/w, and the molar ratio ofphosphatidylserine lipid to polypeptide is in the range of 8:1 to 20:1.In some embodiments, the buffer is Tris at 5.6 to 7.6 percent w/w. Insome embodiments, the buffer is citrate buffer at 9 to 13 percent w/w.In some embodiments, the buffer is acetate buffer at 3 to 5 percent w/w.In certain embodiments, the phosphatidylserine lipid includes one ormore of dioleoyl phosphatidylserine (DOPS), dihexanoylphosphatidylserine lipid, dioctanoyl phosphatidylserine lipid,didecanoyl phosphatidylserine lipid, dilauroyl phosphatidylserine lipid,dimyristoyl phosphatidylserine lipid, dipalmitoyl phosphatidylserinelipid, palmitoyl-oleoyl phosphatidylserine lipid, 1-stearoyl-2-oleoylphosphatidylserine lipid, or diphytanoyl phosphatidylserine lipid. Invarious cases, the composition includes or consists of the polypeptideamino acid sequence of SEQ ID NO: 1, or includes the sequence of SEQ IDNO:1 with one or two amino acid insertions, substitutions, or deletions.In some embodiments, this composition includes t-butyl alcohol in anamount less than 3 percent w/w. In a preferred embodiment, the solidcomposition includes: a polypeptide including the amino acid sequence ofSEQ ID NO: 1 at a concentration of 3.3 to 4.3 percent w/w; DOPS (e.g.,the sodium salt) at a concentration of 3.4 to 4.8 percent w/w; Tris at aconcentration of 6.0 to 7.2 percent w/w; trehalose at a concentration of81 to 87.3 percent w/w; and t-butyl alcohol at a concentration of lessthan 3 percent w/w.

Also described is a pharmaceutical composition that includes: apolypeptide including the amino acid sequence of SEQ ID NO: 1 with zeroto four amino acid insertions, substitutions, or deletions; aphosphatidylserine lipid; a buffer at pH 5.0 to 8; trehalose at 1.5 to 9percent w/v; and water. The polypeptide is at a concentration of 0.4 to5 mg/ml, and the molar ratio of phosphatidylserine lipid to polypeptideis in the range of 8:1 to 20:1. In some embodiments, the buffer is Trisat a concentration of 10 to 50 mM, and the pH of the composition is pH6.8 to 7.6. In some embodiments, the buffer is citrate buffer at aconcentration of 10 to 50 mM. In some embodiments, the buffer is acetatebuffer at a concentration of 10 to 50 mM. In certain embodiments, thephosphatidylserine lipid comprises one or more of DOPS, dihexanoylphosphatidylserine lipid, dioctanoyl phosphatidylserine lipid,didecanoyl phosphatidylserine lipid, dilauroyl phosphatidylserine lipid,dimyristoyl phosphatidylserine lipid, dipalmitoyl phosphatidylserinelipid, palmitoyl-oleoyl phosphatidylserine lipid, 1-stearoyl-2-oleoylphosphatidylserine lipid, or diphytanoyl phosphatidylserine lipid, andpreferably is DOPS, e.g., the sodium salt of DOPS. In various cases, thepolypeptide comprises or consists of the amino acid sequence of SEQ IDNO: 1, or comprises or consists of the sequence of SEQ ID NO:1 with oneor two amino acid insertions, substitutions, or deletions. In someembodiments, this composition includes t-butyl alcohol in an amount lessthan 3 percent. In a preferred embodiment, the composition includes: apolypeptide including the amino acid sequence of SEQ ID NO: 1 at aconcentration of 1.9 to 2.5 mg/ml; DOPS (preferably in its sodium saltform) at a concentration of 2.0 to 2.8 mg/ml; Tris at a concentration of23 to 27 mM; trehalose at a concentration of 4 to 6 percent w/w; t-butylalcohol in an amount less than 0.5 percent w/w; with pH in the range ofpH 6.8 to 7.6 (more preferably pH 7.0 to 7.4, or pH 7.1 to 7.3). Alsodescribed is a method for treating cancer, which may be a solid tumor.Examples of cancers treatable in the method include glioma, ependymoma,and gastrointestinal cancer such as rectal adenocarcinoma. The methodincludes administering to a human cancer patient a pharmaceuticalcomposition described herein. In some embodiments, the method includesreconstituting the solid composition described herein in water or salineto produce a reconstituted composition, and intravenously administeringa dose of the reconstituted composition to the patient. In someembodiments, the composition is delivered intravenously in a doseranging from 0.4 mg/kg to 7 mg/kg SapC, and the ratio of SapC to DOPS inthe composition is in the range of 1.8 to 1:20. In another embodiment,the composition is delivered intravenously in a dose of 2.3-2.5 mg/kgSapC, and the ratio of SapC to DOPS in the composition is in the rangeof 1:11 to 1:13. In some embodiments, the composition is administeredrepeatedly to the patient over at least two cycles, as follows:

-   Cycle 1:

week 1: one dose on each of days 1-5;

week 2: 3×/week every other day, e.g. one dose on each of days 8, 10,and 12;

weeks 3 and 4: one dose each week (every 7 (+/−3) days);

-   Cycle 2:

one dose during week 5; and

-   any subsequent cycle:

one dose 28 (+/−3) days after the most recent prior dose.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a graph depicting results of DSC analysis of sample 75312-F10.

FIG. 2 is a graph depicting results of CD analysis of samples listed inTable 2.

FIG. 3 is a graph depicting the percentage of α-helix and random coil asestimated from CD analysis of samples listed in Table 2.

FIG. 4 is a graph depicting, for each sample listed in Table 4, theoptical density value at 310 nm.

FIG. 5 is a graph depicting SE-HPLC measurements of SapC purity at t=0and after 10 days at 60° C. for samples listed in Table 4.

FIG. 6 is a graph depicting RP-HPLC measurements of SapC purity at t=0and after 10 days at 60° C. for samples listed in Table 4.

FIG. 7 is a graph depicting IEX-HPLC measurements of SapC purity at t=0and after 10 days at 60° C. for samples listed in Table 4.

FIG. 8 is a graph depicting optical density when assayed at 310 nm foreach Table 8 composition at t=0 and after 10 days at 60° C.

FIG. 9 is a graph depicting RP-HPLC measurements of SapC purity of Table8 compositions at t=0 and after 10 days at 60° C.

FIG. 10 is a graph depicting SE-HPLC measurements of SapC purity ofTable 8 compositions at t=0 and after 10 days at 60° C.

FIG. 11 is a graph depicting IEX-HPLC measurements of SapC purity ofTable 8 compositions at t=0 and after 10 days at 60° C.

FIG. 12 is a graph depicting the pH of each sample in Example 4.

FIG. 13 is a graph depicting the protein content of each sample inExample 4.

FIG. 14 is a graph depicting RP-HPLC measurements of SapC purity andpercent recovery in reconstituted compositions at t=0 and after storagefor 2 weeks at 50° C. for samples listed in Table 14.

FIGS. 15A-B are graphs depicting results of dynamic light scattering forsample 76114-F5 at t=0 (A) and after 5 weeks (B) at 50° C.

FIGS. 16A-B are graphs depicting results of dynamic light scattering forsample 76114-F6 at t=0 (A) and after 5 weeks (B) at 50° C.

FIG. 17 is a graph depicting results of dynamic light scattering foreach reconstituted sample at t=0 for samples listed in Table 21.

FIG. 18 is a graph depicting change in dynamic light scattering for eachreconstituted sample over time for samples listed in Table 21.

FIG. 19 is a graph depicting TBA percentage in each reconstituted sampleof the Table 22 compositions.

FIG. 20 is a graph depicting TBA percentage in each reconstituted sampleof the Table 23 compositions.

FIGS. 21A-D are graphs showing particle size distributions for threereplicates of reconstituted liquids for some of the Table 23compositions.

FIG. 22 is a graph depicting RP-HPLC measurements of SapC purity in eachreconstituted composition prepared from lyophilized powder that had beenstored at 25° C. for 2 or 4 weeks, for samples listed in Table 26.

FIG. 23 is a graph depicting IEX-HPLC measurements of SapC purity ineach reconstituted composition prepared from lyophilized powder that hadbeen stored at 25° C. for 2 or 4 weeks, for samples listed in Table 26.

FIG. 24 is a graph depicting average particle size over time in eachreconstituted composition prepared from lyophilized powder that had beenstored at 25° C. for 2 or 4 weeks, for samples listed in Table 26.

FIG. 25 is a graph showing results of a GBA enzyme assay testingactivity of composition comprising SapC and DOPS.

FIG. 26 is a table showing Phase 1a demographics and adverse events bydosing group.

FIGS. 27A-C are three sets of graphs illustrating the mean SapC plasmaconcentration-time profiles upon multiple dose intravenousadministration of BXQ-350 over 0.75 h every 24 hours on Day 1 (FIG.27A), Day 4 (FIG. 27B), and Day 22 (FIG. 27C) in patients with solidtumors (log linear).

FIGS. 28A-D are depictions of results from post-mortem histology andgross anatomy analysis; from left to right: (A) The initial surgicalspecimen showed little evidence of ependymal differentiation andabundant mitotic figures. H&E at 40×; (B) Gross brain examination atautopsy showed extensive tumor necrosis; (C) Microscopic examination ofsections of tumor shows little viable tumor and necrosis (H&E at 4× withinsert at 40×); (D) At autopsy there was extensive chondroiddifferentiation at the site where tumor extended through the surgicaldefect and scalp.

FIG. 29 is a swimmer plot illustrating patient outcomes in a Phase 1Aclinical trial.

FIGS. 30A-B are a pair of positron emission tomography (PET) images atthe start of treatment (FIG. 30A) and after more than 12 months oftreatment (FIG. 30B).

DETAILED DESCRIPTION

The present invention relates to compositions and methods for treatingcancer such as solid tumors, including brain cancers. The compositionsinclude a saposin polypeptide, such as saposin C (SapC), and aphosphatidylserine or structural analog thereof, for exampledioleoylphosphatidylserine (DOPS).

The terms “amino acid” or “amino acid sequence,” as used herein, referto an oligopeptide, peptide, polypeptide, or protein sequence, or afragment of any of these, and to naturally occurring or syntheticmolecules. Where “amino acid sequence” is recited herein to refer to anamino acid sequence of a naturally occurring protein molecule, “aminoacid sequence” and like terms are not meant to limit the amino acidsequence to the complete native amino acid sequence associated with therecited protein molecule.

A “deletion,” as the term is used herein, refers to a change in theamino acid or nucleotide sequence that results in the absence of one ormore amino acid residues or nucleotides.

The words “insertion” or “addition,” as used herein, refer to changes inan amino acid or nucleotide sequence resulting in the addition of one ormore amino acid residues or nucleotides, respectively, to the sequencefound in the naturally occurring molecule.

The term “fusogenic protein or polypeptide” as used herein refers to aprotein or peptide that when added to two separate bilayer membranes canbring about their fusion into a single membrane. The fusogenic proteinforces the cell or model membranes into close contact and causes them tofuse. Suitable lysosomal fusogenic proteins and polypeptides for use inthis invention include, but are not limited to, proteins of the saposinfamily.

As used herein, the term “saposin” refers to the family ofprosaposin-derived proteins and polypeptides, including but not limitedto naturally occurring saposins A, B, C and D (from human or otheranimal species such as mouse, rat, pig, and cow; see, e.g., Qi et al.(1996) J. Biol. Chem. 271(12):6874-6880 (incorporated by reference)), aswell as synthetic saposin-derived proteins and peptides and peptideanalogs showing fusogenic activity. In certain embodiments, the saposinpolypeptide comprises or consists of the amino acid sequence of humanSapC: Ser Asp Val Tyr Cys Glu Val Cys Glu Phe Leu Val Lys Glu Val ThrLys Leu Ile Asp Asn Asn Lys Thr Glu Lys Glu Ile Leu Asp Ala Phe Asp LysMet Cys Ser Lys Leu ProLys Ser Leu Ser Glu Glu Cys Gln Glu Val Val AspThr Tyr Gly Ser Ser Ile Leu Ser Ile Leu Leu Glu Glu Val Ser Pro Glu LeuVal Cys Ser Met Leu His Leu Cys Ser Gly (SEQ ID NO:1). In otherembodiments, the SapC polypeptide comprises the amino acid sequence ofSEQ ID NO:1 with zero to four amino acid insertions, substitutions, ordeletions, e.g., a total of one, two, three or four of such changes. Insome embodiments, the SapC polypeptide's amino acid sequence comprisesSEQ ID NO:1 with one or two amino acid insertions, substitutions, ordeletions, or a combination of such changes. Also included arepolypeptides analogs possessing some degree of the fusogenic activity ofhuman SapC. By “analog” is meant a polypeptide with substitutions orother alterations in the amino acid sequence of SapC, whichsubstitutions or alterations do not adversely affect the fusogenicproperties of the polypeptide. Thus, an analog might be a polypeptidehaving an amino acid sequence substantially identical to SEQ ID NO:1 andin which one or more amino acid residues have been conservativelysubstituted with chemically similar amino acids. Examples ofconservative substitutions include the substitution of a non-polar(hydrophobic) residue such as isoleucine, valine, leucine or methioninefor another. Likewise, the present invention contemplates thesubstitution of one polar (hydrophilic) residue such as between arginineand lysine, between glutamine and asparagine, and between glycine andserine. The substitution of a basic residue such as lysine, arginine orhistidine for another or the substitution of one acidic residue such asaspartic acid or glutamic acid for another is also contemplated.

SapC and polypeptides derived therefrom may be produced by any usefulmethod, such as, for example, chemically, enzymatically, orrecombinantly. Methods for producing polypeptides and fragments thereofare known in the art and include, but are not limited to, chemicalpeptide synthesis, in vitro translation systems, and expression (andpurification from) a recombinant host organism.

“Lipid vesicle” and “liposome” are used interchangeably to refer to agenerally spherical cluster or aggregate of amphipathic lipids,typically in the form of one or more concentric layers, for example,bilayers.

The terms “phosphatidylserine” and “phosphatidylserine lipid” are usedinterchangeably to refer to lipids that have two fatty acids attached inester linkage to the first and second carbon of glycerol and a serinemoiety attached through a phosphodiester linkage to the third carbon ofthe glycerol. Examples of phosphatidylserine lipids that may be usedwith the present compositions include but are not limited to thefollowing: dioleoyl phosphatidylserine lipid (DOPS); dihexanoylphosphatidylserine lipid; dioctanoyl phosphatidylserine lipid;didecanoyl phosphatidylserine lipid; dilauroyl phosphatidylserine lipid;dimyristoyl phosphatidylserine lipid; dipalmitoyl phosphatidylserinelipid; palmitoyl-oleoyl phosphatidylserine lipid; 1-stearoyl-2-oleoylphosphatidylserine lipid; and diphytanoyl phosphatidylserine lipid, withDOPS being preferred. In aqueous compositions at neutral pH, suchphosphatidylserine lipids typically exist in the form of a salt with acation, and so references to DOPS and other phosphatidylserine lipidsused in the present compositions are meant to include both the salt andnon-salt forms of the lipids. Suitable cations include anypharmaceutically acceptable cation that forms a salt with thephosphatidylserine lipid, such as any of the following: ammonium ion;L-arginine ion; benzathine ion; deanol ion; diethanolamine(2,2′-iminodiethanol) ion; hydrabamine ion; lysine ion; potassium ion;sodium ion; triethanolamine (2,2′,2″-nitrilotri(ethan-1-ol)) ion; andtromethamine (2-amino-2-(hydroxymethyl)propane-1,3-diol ion. The sodium,potassium, and ammonium salts are preferred.

The compositions of the present invention may contain buffering agents.Exemplary buffering agents include but are not limited to acetate,citrate, histidine, succinate, and tris(hydroxymethyl)aminomethane(Tris; also known as tromethamine), as well as known derivatives ofTris, such as those in which the amino group is modified. In a preferredembodiment, the present aqueous compositions contain Tris at aconcentration of 10 to 50 mM (preferably 20 to 30 mM, e.g., 25 mM), andthe pH of these compositions ranges from pH 6.8 to 7.6 (e.g., pH 7 to7.4, e.g., pH 7.1 to 7.3). In some embodiments, the compositions containcitrate buffer or acetate buffer at a concentration of 10 to 50 mM, andthe pH of the compositions ranges from pH 5.0 to 8.0.

Biocompatible polymers useful as stabilizing materials and/or bulkingagents may be of natural, semi-synthetic (modified natural) or syntheticorigin. As used herein, the term polymer denotes a compound comprised oftwo or more repeating monomeric units, and preferably 10 or morerepeating monomeric units. The term semi-synthetic polymer (or modifiednatural polymer), as employed herein, denotes a natural polymer that hasbeen chemically modified in some fashion. Exemplary natural polymerssuitable for use in the present invention include naturally occurringpolysaccharides. Such polysaccharides include, for example, arabinans,fructans, fucans, galactans, galacturonans, glucans, mannans, xylans(such as inulin), levan, fucoidan, carrageenan, galatocarolose, pecticacid, pectin, amylose, pullulan, glycogen, amylopectin, cellulose,dextran, dextrin, dextrose, polydextrose, pustulan, chitin, agarose,keratan, chondroitan, dermatan, hyaluronic acid, alginic acid, xanthangum, starch, and various other natural homopolymers or heteropolymers,such as those containing one or more of the following aldoses, ketoses,acids or amines: erythrose, threose, ribose, arabinose, xylose, lyxose,allose, altrose, lucose, mannose, gulose, idose, galactose, talose,erytirulose, ribulose, xylulose, psicose, fructose, sorbose, tagatose,mannitol, sorbitol, lactose, sucrose, trehalose, maltose, cellobiose,glycine, serine, threonine, cysteine, tyrosine, asparagine, glutamine,aspartic acid, glutamic acid, lysine, arginine, histidine, glucuronicacid, gluconic acid, glucaric acid, galacturonic acid, mannuronic acid,glucosamine, galactosamine, and neuraminic acid, and naturally occurringderivatives thereof. Exemplary semi-synthetic polymers includecarboxymethylcellulose, hydroxymethylcellulose,hydroxypropylmethylcellulose, methylcellulose, and methoxycellulose.Exemplary synthetic polymers suitable for use in the present inventioninclude polyethylenes (such as, for example, polyethylene glycol (PEG),polyoxyethylene, and polyethylene terephthalate), polypropylenes (suchas, for example, polypropylene glycol), polyurethanes (such as, forexample, polyvinyl alcohol (PVA), polyvinyl chloride andpolyvinylpyrrolidone (PVP)), polyamides including nylon, polystyrene,polylactic acids, fluorinated hydrocarbons, fluorinated carbons (such aspolytetrafluoroethylene), and polymethylmethacrylate, and derivatives ofany of these. Methods for the preparation of vesicle compositions thatemploy polymers as stabilizing compounds will be readily apparent tothose skilled in the art, once armed with the present disclosure, whenthe present disclosure is coupled with information known in the art,such as that described and referred to in U.S. Pat. No. 5,205,290, thedisclosures of which are hereby incorporated herein by reference intheir entirety. In preferred form, the present compositions contain oneor more of mannitol, lactose, trehalose, sucrose, PEG, PVP, sorbitol, orglucose.

A wide variety of techniques are available for the preparation of theclaimed compositions. In a preferred embodiment, DOPS or anotherphosphatidylserine lipid is solubilized with organic solvent and thencombined with the aqueous-based ingredients, including SapC, at ambienttemperature for 5-15 minutes. Exemplary organic solvents that may beused for this purpose include but are not limited to ethanol, DMSO,n-butanol, and t-butanol (also known as t-butyl alcohol, TBA). In apreferred embodiment, the organic solvent is t-butanol, e.g., at over98% purity. When the ingredients are mixed, the lipid and SapC togetherform into vesicles suspended in the aqueous solution. Lyophilization ofthe mixture drives off not only the water, but also most or all of theorganic solvent. In preferred embodiments, the lyophilized powdercontains less than 3% w/w TBA.

A wide variety of techniques known to those of ordinary skill in the artcan be used to prepare liposome compositions. These techniques include,for example, solvent dialysis, French press, extrusion (with or withoutfreeze-thaw), reverse phase evaporation, simple freeze-thaw, sonication,chelate dialysis, homogenization, solvent infusion, microemulsification,spontaneous formation, solvent vaporization, solvent dialysis,controlled detergent dialysis, and others. See, e.g., Madden et al.,Chemistry and Physics of Lipids, 1990 53, 37-46, the disclosures ofwhich are hereby incorporated herein by reference in their entirety.Suitable freeze-thaw techniques are described, for example, inInternational Application Ser. No. PCT/US89/05040, filed Nov. 8, 1989,the disclosures of which are incorporated herein by reference in theirentirety. Preparation of the liposomes may be carried out in a solution,such as an aqueous saline solution, aqueous phosphate buffer solution,or sterile water. The liposomes may be prepared by various processesthat involve shaking or vortexing.

Many liposomal preparatory techniques that may be adapted for use in thepreparation of vesicle compositions are discussed, for example, in U.S.Pat. No. 4,728,578; U.K. Patent Application GB 2193095 A; U.S. Pat. Nos.4,728,575; 4,737,323; International Application Ser. No. PCT/US85/01161;Mayer et al., Biochimica et Biophysica Acta, Vol. 858, pp. 161-168(1986); Hope et al., Biochimica et Biophysica Acta, Vol. 812, pp. 55-65(1985); Mayhew et al., Methods in Enzymology, Vol. 149, pp. 64-77(1987); Mayhew et al., Biochimica et Biophysica Acta, Vol 755, pp.169-74 (1984); Cheng et al, Investigative Radiology, Vol. 22, pp. 47-55(1987); International Application Ser. No. PCT/US89/05040; U.S. Pat.Nos. 4,533,254; 4,162,282; 4,310,505; 4,921,706; and LiposomeTechnology, Gregoriadis, G., ed., Vol. 1, pp. 29-31, 51-67 and 79-108(CRC Press Inc., Boca Raton, Fla. 1984), the disclosures of each ofwhich are hereby incorporated by reference in their entirety.

As those skilled in the art will recognize, any of the vesiclecompositions may be lyophilized for storage and reconstituted, forexample, with a sterile aqueous medium suitable for administration to apatient (such as water, phosphate buffered solution, Tris bufferedsolution, or aqueous saline solution), if necessary with the aid ofvigorous agitation. The liposomes may be lyophilized according tomethods known in the art, including those described in Rey, L. (2010),Freeze-Drying/Lyophilization of Pharmaceutical and Biological Products.ISBN 9781439825754, the relevant parts of which are incorporated byreference. Exemplary lyophilization methods utilize freezing, primarydrying, and secondary drying phases according to parameters disclosed inTable I.

TABLE I Exemplary ranges of lyophilization parameters Pressure,Duration, Cycle Step Temperature, C. mTorr minutes Freezing −40 to −50 —340-960 (no higher than −40) Primary Drying −15 to −25 30-65 2200-4300Secondary Drying 25 to 35 35-65  500-2300 Total Cycle — — 3040-7560

To prevent agglutination or fusion of the lipids and/or vesicles as aresult of lyophilization, it may be useful to include additives thatprevent such fusion or agglutination from occurring. Additives that maybe useful include sorbitol, mannitol, sodium chloride, glucose,trehalose, polyvinylpyrrolidone (PVP) and poly(ethylene glycol) (PEG),for example, PEG 400. These and other additives are described in theliterature, such as in the U.S. Pharmacopeia, USP XXII, NF XVII, TheUnited States Pharmacopeia, The National Formulary, United StatesPharmacopeial Convention Inc., 12601 Twinbrook Parkway, Rockville, Md.20852, the disclosures of which are hereby incorporated herein byreference in their entirety.

The terms “stable” and “stabilized”, as applied to vesicles, mean thatthe vesicles are substantially resistant to degradation, including, forexample, loss of vesicle structure or encapsulated gas or gaseousprecursor, for a useful period of time. The terms “stable” and“stabilized” as applied to the present aqueous compositions containingSapC/lipid vesicles (before lyophilization or after reconstitution ofthe lyophilized powder) mean that there is no significant loss ofcontent or purity of protein or of phosphatidylserine lipid and nosignificant changes in the physical properties. The terms “stable” and“stabilized” as applied to the present lyophilized powder compositionsmean that, upon reconstitution with water for injection, there is nosignificant loss on content or purity of protein and phosphatidylserinelipid and no significant changes on the physical properties.

Cancers that are treatable with the present compositions include, forexample, any solid tumors or neurological cancer, e.g., prostate cancer,liver cancer, lung cancer, pancreatic cancer, renal cell carcinoma,breast cancer, ovarian cancer, testicular cancer, ependymoma, braincancers such as high grade gliomas (HGG) including glioblastomamultiforme (GBM), and gastrointestinal (GI) cancers includingappendiceal and colorectal. The compositions are useful for treatingmetastatic tumors regardless of the primary tumor type or the organwhere it metastasizes. A metastatic tumor can arise from a multitude ofprimary tumor types, including but not limited to those of prostate,colon, lung, breast, and liver origin. The terms “cancer” and “neoplasm”can include malignancies of the various organ systems, such as thoseaffecting the lung, breast, thyroid, lymphoid, gastrointestinal, orgenito-urinary tract, as well as adenocarcinomas which includemalignancies such as most colon cancers, renal-cell carcinoma, prostatecancer and/or testicular tumors, non-small cell carcinoma of the lung,cancer of the small intestine and cancer of the esophagus. The term“carcinoma” is art recognized and refers to malignancies of epithelialor endocrine tissues including respiratory system carcinomas,gastrointestinal system carcinomas, genitourinary system carcinomas,testicular carcinomas, breast carcinomas, prostatic carcinomas,endocrine system carcinomas, and melanomas. Exemplary carcinomas includethose forming from tissue of the cervix, lung, prostate, breast, headand neck, colon and ovary. The term also includes carcinosarcomas, whichinclude malignant tumors composed of carcinomatous and sarcomatoustissues. An “adenocarcinoma” refers to a carcinoma derived fromglandular tissue or in which the tumor cells form recognizable glandularstructures. Further details can be found in, for example, U.S. Pat. No.7,834,147, which is incorporated herein by reference in its entirety.

“Patient” or “subject” refers to an animal, including a mammal,preferably a human.

A therapeutically effective dose or amount of the composition is anamount useful to treat a patient's cancer. In general, a singletherapeutically effective dose of the present composition will containan amount of SapC (or its derivative) in the range of about 0.01 to 30mg/kg body weight, preferably about 0.05 to 20 mg/kg body weight, morepreferably about 0.1 to 15 mg/kg body weight, and even more preferablyabout 0.5 to 10 mg/kg. For example, the amount of SapC in a singleintravenous dose can be about 0.7 mg/kg, 1.1 mg/kg, 1.4 mg/kg, 1.8mg/kg, 2.4 mg/kg, 2.8 mg/kg, 3.0 mg/kg, 3.2 mg/kg, 3.6 mg/kg, or more. Agiven patient may receive a given dose level for one or more initialadministrations and a different (lower or higher) level for furtheradministrations. The delivery may be by any suitable injectable route,e.g., intravenous, intra-arterial, intradermal, intramuscular,intracardiac, intracranial, subcutaneous, or intraperitoneal. Typically,the composition of the invention is reconstituted in sterile water forinjection and is delivered by intravenous infusion in an IV bagcontaining an isotonic carrier, such as saline, PBS, or dextrose 5% byweight (D5W). Further details regarding routes of administration can befound, for example, in U.S. Pat. No. 7,834,147.

Administration can occur at least once a day for some number ofconsecutive days, e.g., for 3, 4, 5, 6, 7, 8, 9, or more consecutivedays, or can be, e.g., every other day, or 3 times a week, or once every7±3 days, or once every 14±3 days, or once every 28±3 days. The timingof administrations can start with one of those schedules and after asuitable period of treatment change to another that is more or lessfrequent. The entire period of treatment can be completed in, e.g.,eight or twelve or sixteen weeks, or up to six months, but morepreferably will continue as long as the patient appears to be benefitingfrom the treatment. For example, the dosing schedule might be:

-   Cycle 1:

week 1: one dose on each of days 1-5;

week 2: 3×/week every other day, e.g. one dose on each of days 8, 10,and 12;

weeks 3 and 4: one dose each week (every 7 (+/−3) days);

-   Cycle 2: one dose during week 5;-   and any subsequent cycle: one dose 28 (+/−3) days after the most    recent prior dose.

The molar ratio of the SapC polypeptide to the phosphatidylserine lipidin a composition of the invention can be in the range from 1:2 to 1:50,for example 1:5 to 1:30, or 1:8 to 1:20, or 1:11 to 1:13. Suitable molarratios include but are not limited to 1:10, 1:11, 1:12, 1:13, 1:14, and1:15. The mass ratio of the polypeptide to the phosphatidlyserine lipidis in the range from about 1:0.18 to about 1:4.5, or about 1:0.45 toabout 1:2.7, or about 1:0.72 to about 1:1.81, or about 1:1 to about1:1.2. It is recognized that the preferred ratio of the polypeptide andlipid in a composition of the invention may be affected by certainfactors such as, but not limited to, the target cell type and the routeof delivery.

Useful background information and technical details can be found in U.S.Pat. Nos. 7,834,147 and 9,271,932, which are incorporated herein byreference in their entirety.

The compositions and methods are further supported by the informationprovided in the following Examples. It is to be understood that theembodiments described in the Examples are merely illustrative, and arenot intended to limit the scope of the present invention, which will belimited only by the appended claims.

EXAMPLES

Materials

The following reagents were purchased from commercial vendors: sodiumcitrate dihydrate, citric acid anhydrous, glycine, sodium phosphatemonobasic monohydrate (EMD), sodium phosphate dibasic heptahydrate(Thermo Scientific), tris(hydroxymethyl)aminomethane (“Tris;” J. T.Baker), L-histidine, sodium chloride, HyClone™ water (ThermoScientific), sodium hydroxide, D-trehalose anhydrous (VWRInternational), D(+) trehalose dihydrate (Spectrum), sucrose (BDHChemicals), mannitol (BDH Chemicals), 0.9% sodium chloride, t-butanol(Sigma Aldrich), 1,2-dioleoyl-sn-glycero-3-phospho-L-serine (DOPS sodiumsalt) (Avanti Polar Lipids).

Saposin C (“SapC”) was prepared by standard methods utilizingrecombinant expression in E. coli cells.

Example 1. Determination of How Select Buffering Agents Affect Stabilityof Compositions Comprising SapC

To determine how buffering agents affect SapC stability, compositions ofSapC in select buffering agents listed in Tables 1 and 2 were preparedand analyzed by differential scanning calorimetry (DSC) and circulardichroism (CD).

Methods

The compositions listed in Table 1 and Table 2 were prepared.

TABLE 1 Compositions prepared for DSC analysis UID Description 75312-F95 mg/mL SapC, 10 mM citrate pH 6 75312-F10 5 mg/mL SapC, 10 mM phosphatepH 7 75312-F11 5 mg/mL SapC, 10 mM Tris pH 7.5 75312-F12 5 mg/mL SapC,10 mM Tris pH 8 75312-F13 5 mg/mL SapC, 10 mM phosphate pH 7.5, 1.68%w/v NaCl 75312-F14 5 mg/mL SapC, 50 mM phosphate pH 7.5, 1.20% w/v NaCl75312-F15 5 mg/mL SapC, 10 mM glycine pH 9

TABLE 2 Compositions prepared for CD analysis UID Description 75312-F1 1mg/mL SapC, 10 mM citrate pH 6 75312-F2 1 mg/mL SapC, 10 mM phosphate pH7 75312-F3 1 mg/mL SapC, 10 mM Tris pH 7.5 75312-F4 1 mg/mL SapC, 10 mMTris pH 8 75312-F5 1 mg/mL SapC, 10 mM phosphate, 1.68% w/v NaCl, pH 7.575312-F6 1 mg/mL SapC, 50 mM phosphate, 1.20% w/v NaCl, pH 7.5 75312-F71 mg/mL SapC, 10 mM glycine pH 9

DSC measurements were performed using a MicroCal™ VP-DSC calorimeter(Northampton, Mass.). Run parameters included a temperature range of 10to 110° C., scan rate of 60° C. per hour, and filtering period of 16seconds. The samples were pre-equilibrated for 15 minutes prior to eachscan. The thermograms were processed using the MicroCal™ VP-DSCcalorimeter add-on module for Origin version 7. A DSC melt detects theunfolding of a protein by monitoring the change in enthalpy associatedwith the event. Protein unfolding is commonly exothermic and is markedby a peak in the thermogram reading, with the apex depicting thetransition at which half of the protein molecules are unfolded. A highmelting temperature (Tm) signifies a high intrinsic conformationalstability.

CD measurements were performed using a Chirascan™-plusspectropolarimeter (Leatherhead, UK) with a 4-position peltiertemperature controller. A far-UV spectrum of each sample was obtainedover a wavelength range of 180-260 nm at 10° C. using a 0.1 cm pathlength cuvette. The spectra of respective control samples weresubtracted from the spectra for corresponding test samples. The percentof secondary structure was estimated using CDNN software provided withthe instrument. It was determined that samples with 1 mg/mL SapCconcentration needed to be diluted to avoid saturation at the lowerwavelengths of the CD spectra. Therefore, a 6-fold dilution wasperformed for each of the samples prior to CD measurements.

Results

FIG. 1 is a graph depicting results of DSC analysis of sample 75312-F10.The thermogram for sample 75312-F10, and also for all samples tested(data not shown), lacked a transition expected for protein unfolding.Without wishing to be bound to a particular theory, applicantshypothesize that either (1) the SapC protein lacks tertiary structure(s)or (2) the SapC protein does not unfold even up to the highesttemperature of 110° C.

FIG. 2 is a graph depicting results of CD analysis of samples listed inTable 2. The CD spectra of all samples exhibit minima at approximately208 and 220 nm, a characteristic indicative of significant α-helixcontent. Analysis of the spectra revealed a pH-dependence in themagnitudes of the spectra in order of pH 7.0>7.5≈6.0>8.0>9.0.

The percent of secondary structure for each sample was estimated fromthe CD spectra using methods known in the art and is reported in Table3. FIG. 3 is a graph depicting the percentage of α-helix and random coilas estimated from CD analysis of samples listed in Table 2. Notably, thehighest and lowest amounts of α-helix correlated with sample pH, withhighest amount in 75312-F2 (pH 7) and the lowest in 75312-F7 (pH 9).These data indicate that SapC likely retains activity, as inferred fromthe preservation of secondary structure components, when stored inphosphate at pH 7 or in Tris pH 7.6 These data also indicate thatvarying buffer concentration, specifically 10 or 50 mM phosphate(comparison of 75312-F5 to 75312-F6), while holding tonicity constantdid not confer differences in secondary structure of SapC.

TABLE 3 Estimated percent secondary structure in each composition Anti-parallel Parallel Random Total UID Helix β-sheet β-sheet β-turn coil sum75312-F1 64.9 3.2 3.3 12.5 14.0 97.9 75312-F2 83.4 1.4 1.6 9.7 7.2 103.475312-F3 69.6 2.7 2.8 11.8 12.5 99.4 75312-F4 46.6 5.7 5.8 14.9 23.196.2 75312-F5 45.4 6.0 6.0 15.1 23.5 96.0 75312-F6 47.0 5.7 5.7 14.922.8 96.1 75312-F7 21.0 13.6 13.0 19.6 42.1 109.4

Example 2. Determination of How Select Buffering Agents (andConcentrations) Affect Stability and Purity of SapC Compositions Storedat 60° C.

To determine how various buffering agents affect stability and purity ofcompositions comprising SapC, compositions of SapC in select bufferingagents listed in Table 4 were prepared, stored at 60° C., and analyzedby visual appearance, total protein content, and purity of proteincontent.

Methods

The compositions listed in Table 4 were prepared. Some samples werefrozen immediately upon preparation (t=0 days) and held at −70° C. untiltime for analysis; others were stored for 10 days at 60° C. (t=10 days)before being frozen and held at −70° C. until time for analysis. Thefrozen samples were then thawed to room temperature and the followingproperties were assayed: (1) appearance assessed by visualcharacterization of liquid under bright light to observe clarity, color,and presence of any particulate matter in the sample; (2) pH quantifiedby pH meter; (3) total protein content quantified by UV analysis at 280nm using an extinction coefficient of 0.395 mg⁻¹ mL cm⁻¹; (4) purity ofprotein content, specifically the percentage of full length SapC in thesample and the presence of (and concentration of) SapC degradationproducts as assessed by SE-HPLC, RP-HPLC, and IEX-HPLC. SE-HPLC,RP-HPLC, and IEX-HPLC are chromatography methods that separate theanalyte by size, by hydrophobicity, and by charge variants,respectively.

TABLE 4 List of compositions UID Description 183-001-01-095-F1 2 mg/mLSapC, 10 mM histidine pH 6 183-001-01-095-F2 2 mg/mL SapC, 50 mMhistidine pH 6 183-001-01-095-F3 5 mg/mL SapC, 10 mM histidine pH 6183-001-01-095-F4 5 mg/mL SapC, 50 mM histidine pH 6 183-001-01-095-F5 2mg/mL SapC, 10 mM phosphate pH 6.8 183-001-01-095-F6 2 mg/mL SapC, 50 mMphosphate pH 6.8 183-001-01-095-F7 5 mg/mL SapC, 10 mM phosphate pH 6.8183-001-01-095-F8 5 mg/mL SapC, 50 mM phosphate pH 6.8 183-001-01-095-F92 mg/mL SapC, 10 mM Tris pH 7.6 183-001-01-095-F10 2 mg/mL SapC, 50 mMTris pH 7.6 183-001-01-095-F11 5 mg/mL SapC, 10 mM Tris pH 7.6183-001-01-095-F12 5 mg/mL SapC, 50 mM Tris pH 7.6Results

The visual appearances of the samples are summarized in Table 5. At t=0days, 183-001-01-095-F2, -F4, -F5, -F6, and -F7 were free of visibleparticles, while 183-001-01-095-F1, -F3, -F8, -F9, -F10, -F11, and F12were mostly clear with a few particles. After incubation at 60° C. for10 days, all samples had a few particles, with phosphate-buffered183-001-01-095-F5, -F6, and -F8 having “long” particles. Additionally,some histidine and phosphate-containing samples took on a slight yellowtint, specifically 183-001-01-095-F3, -F4, -F7, and -F8.

TABLE 5 Appearance of each composition after t = 0 and t = 10 days UID t= 0 days t = 10 days 183-001-01-095-F1 Clear, colorless, Clear,colorless, few particles few particles 183-001-01-095-F2 Clear,colorless, Clear, slight free of visible yellow tint, few particlesparticles 183-001-01-095-F3 Clear, colorless, Clear, slight fewparticles yellow tint, few particles 183-001-01-095-F4 Clear, colorless,Clear, slight free of visible yellow tint, few particles particles183-001-01-095-F5 Clear, colorless, Clear, colorless, free of visiblefew long particles particles 183-001-01-095-F6 Clear, colorless, Clear,colorless, free of visible few long particles particles183-001-01-095-F7 Clear, colorless, Clear, slight free of visible yellowtint, few particles particles 183-001-01-095-F8 Clear, colorless, Clear,slight few particles yellow tint, few long particles 183-001-01-095-F9Clear, colorless, Clear, colorless, few particles few particles183-001-01-095-F10 Clear, colorless, Clear, colorless, few particles fewparticles 183-001-01-095-F11 Clear, colorless, Clear, colorless, fewparticles few particles 183-001-01-095-F12 Clear, colorless, Clear,colorless, few particles few particles

The pH of each sample is reported in Table 6. The samples buffered byphosphate (183-001-01-095-F5, -F6, -F7, -F8) drifted to a more basic pHthan their target pH of 6.8, at both time points. Notably, the pH ofsamples buffered by 10 mM phosphate (183-001-01-095-F5 and -F7) driftedmore than the samples buffered with 50 mM phosphate (183-001-01-095-F6and -F8). All the samples buffered with histidine (183-001-01-095-F1,-F2, -F3, and -F4) or Tris (183-001-01-095-F9, -F10, -F11, and -F12)maintained their initial pH value to within 0.1 pH units.

TABLE 6 pH of each sample after t = 0 and t = 10 days UID t = 0 days t =10 days 183-001-01-095-F1 6.12 6.11 183-001-01-095-F2 5.98 5.96183-001-01-095-F3 6.22 6.25 183-001-01-095-F4 6.01 6.01183-001-01-095-F5 7.31 7.29 183-001-01-095-F6 7.10 7.09183-001-01-095-F7 7.25 7.30 183-001-01-095-F8 7.08 7.09183-001-01-095-F9 7.55 7.57 183-001-01-095-F10 7.54 7.54183-001-01-095-F11 7.59 7.60 183-001-01-095-F12 7.52 7.53

The total protein content in each of the samples is reported in Table 7.At t=0, all samples exhibited protein concentrations that were close tothe target values of either 2 or 5 mg/mL. At t=10 days, however, amajority of the samples had increased protein concentration. Theseinflated numbers are probably an artifact of spectral scattering due tothe increase in large particles in the samples. To quantify the increasein scattering, optical density scans (200 to 400 nm) were measured foreach sample to evaluate the extent of scattering increase upon storage.FIG. 4 is a graph depicting for each sample the optical density value at310 nm, a wavelength devoid of significant absorption signal (note thatsample 183-001-01-095-F11 was not analyzed). The samples buffered byhistidine at pH 6 (183-001-01-095-F1, -F2, -F3, and -F4) and samplesbuffered by phosphate at pH 6.8 (183-001-01-095-F5, -F6, -F7, and -F8)exhibited increased scattering after 10 days. Notably, the samples183-001-01-095-F9, -F10, and -F12 buffered by Tris at pH 7.6 exhibitedminimal increases in scattering after 10 days.

TABLE 7 Total protein content (mg/mL) in compositions after t = 0 and t= 10 days UID t = 0 days t = 10 days 183-001-01-095-F1 2.01 2.34183-001-01-095-F2 2.08 3.12 183-001-01-095-F3 4.82 5.57183-001-01-095-F4 4.97 6.70 183-001-01-095-F5 2.08 2.36183-001-01-095-F6 2.13 2.52 183-001-01-095-F7 4.99 5.53183-001-01-095-F8 5.00 5.92 183-001-01-095-F9 2.07 2.09183-001-01-095-F10 2.03 2.09 183-001-01-095-F11 5.05 5.18183-001-01-095-F12 4.99 5.22

The purity of SapC in the samples was estimated by SE-HPLC, RP-HPLC, andIEX-HPLC. The purity of SapC in the samples was quantified as thepercentage of protein content detected in elution peak comprising fulllength SapC. FIG. 5 is a graph depicting SE-HPLC measurements of SapCpurity at t=0 and after 10 days at 60° C. All samples exhibited greaterthan 95 percent purity of SapC after 10 days, as detected by SE-HPLC.Notably, the samples buffered by histidine at pH 6 (183-001-01-095-F1,-F2, -F3, and -F4) and samples buffered by phosphate at pH 6.8(183-001-01-095-F5, -F6, -F7, and -F8) that exhibited increasedscattering at OD 310 nm were expected to contain higher order molecularweight species (i.e., aggregates); however, no such species wereobserved by SE-HPLC in these samples. If these supposed aggregates weretoo large to pass through the column, then the apparent concentration ofthe protein (based on chromatographic area) would have decreased. This,too, was not observed, as SapC main peak recovery was high even after 10days in those samples. Without wishing to be bound to a particulartheory, applicants note a possibility that could explain these resultsis that the particulate matter observed in F1-F8 does not comprise, orcomprises a negligible amount of, SapC or fragments of SapC.

FIG. 6 is a graph depicting RP-HPLC measurements of SapC purity at t=0and after 10 days at 60° C. All samples exhibited some degree ofdecreased SapC purity after 10 days, as measured by RP-HPLC. The samplesbuffered by phosphate pH 6.8 (183-001-01-095-F5, -F6, -F7, and -F8)exhibited the largest decreases in SapC purity.

FIG. 7 is a graph depicting IEX-HPLC measurements of SapC purity at t=0and after 10 days at 60° C. All samples exhibited some degree ofdecreased SapC purity after 10 days, as measured by IEX-HPLC. As wastrue when the measurements were done with RP-HPLC (see above), thesamples buffered by phosphate pH 6.8 (183-001-01-095-F5, -F6, -F7, and-F8) exhibited the largest decreases in SapC purity.

In sum, these data indicate that samples comprising Tris at pH 7.6exhibited higher stability and purity compared to samples comprisinghistidine at pH 6 or phosphate at pH 6.8.

Example 3. Determination of How Select Concentrations of Citrate at pH6.2 Affects Stability and Purity of Compositions Comprising SapC Exposedto 60° C.

To determine how citrate affects the stability and purity ofcompositions comprising SapC, various compositions of SapC in citrate atpH 6.2 were prepared, stored at 60° C., and analyzed by appearance, pH,protein content, and chromatography methods.

Methods

Samples of the compositions listed in Table 8 were taken at t=0(immediately upon preparation) and after storage at 60° C. for 10 days(t=10 days), then frozen and stored at −70° C. until time for analysis.The frozen compositions were thawed to room temperature, and thefollowing properties were assayed as described in Example 2: visualappearance, pH, total protein content, and purity of protein content.

TABLE 8 Citrate-containing compositions UID Description 82014-F1 2 mg/mLSapC, 10 mM citrate pH 6.2 82014-F2 2 mg/mL SapC, 50 mM citrate pH 6.282014-F3 5 mg/mL SapC, 10 mM citrate pH 6.2 82014-F4 5 mg/mL SapC, 50 mMcitrate pH 6.2 82014- citrate control 1 10 mM citrate pH 6.2 82014-citrate control 2 50 mM citrate pH 6.2Results

The visual appearance and pH of each sample are reported in Table 9. Allof the samples were clear and colorless liquids at both time points. ThepH of all samples was maintained within 0.2 pH units of the initial pHvalue after 10 days at 60° C.; however, the initial pH of all sampleswas more basic than the targeted pH 6.2.

TABLE 9 Visual appearance and pH for each sample after t = 0 and t = 10days Sample # Time Point Appearance pH 82014-F1 t = 0 Clear, colorlesssolution 6.62 t = 10 Clear, colorless solution 6.63 82014-F2 t = 0Clear, colorless solution 6.32 t = 10 Clear, colorless solution 6.2682014-F3 t = 0 Clear, colorless solution 6.71 t = 10 Clear, colorlesssolution 6.92 82014-F4 t = 0 Clear, colorless solution 6.31 t = 10Clear, colorless solution 6.32 82014-Citrate Control 1 t = 0 Clear,colorless solution 6.48 t = 10 Clear, colorless solution 6.6482014-Citrate Control 2 t = 0 Clear, colorless solution 6.29 t = 10Clear, colorless solution 6.31

FIG. 8 is a graph depicting optical density when assayed at 310 nm foreach Table 8 composition at t=0 and after 10 days at 60° C. Nocomposition exhibited a significant increase in optical density at 310nm after 10 days.

FIG. 9 is a graph depicting RP-HPLC measurements of SapC purity of Table8 compositions at t=0 and after 10 days at 60° C. All compositionsexhibited decreased SapC purity after 10 days by this measure.

FIG. 10 is a graph depicting SE-HPLC measurements of SapC purity ofTable 8 compositions at t=0 and after 10 days at 60° C. All compositionsexhibited no marked changes for SapC purity after 10 days.

FIG. 11 is a graph depicting IEX-HPLC measurements of SapC purity ofTable 8 compositions at t=0 and after 10 days at 60° C. All samplesexhibited decreased SapC purity after 10 days by this measure.

In sum, these data indicate that samples comprising either 2 or 5 mg/mLSapC and either 10 or 50 mM citrate at a target pH of pH 6.2 (actual pHup to 6.64) exhibited similar stability and purity over 10 days at 60°C. Based on this data and the data of previous Examples, potentialbuffering agents for compositions comprising SapC include, but are notlimited to, citrate at an approximate pH of 6.2 and Tris at anapproximate pH of 7.6.

Example 4. Determination of Stability of Compositions Comprising SapCand 25 mM Tris pH 7.2 Following Exposure to Either Mechanical or ThermalStress

To quantify the stability of compositions comprising SapC and 25 mM TrispH 7.2 following exposure to mechanical or thermal stress, thecompositions were exposed to mechanical or thermal stress and analyzedby visual appearance, pH, and total protein content.

Methods

Composition 183-001-01-220-F1 comprising 5 mg/mL SapC, 25 mM Tris pH7.1-7.2 was prepared, and samples of it were exposed either tofreeze-thaw stress or to agitation stress. For each sample, thefollowing properties were assayed as described in Example 2: visualappearance, pH, and total protein content.

For freeze-thaw stress testing, samples were divided into 1.3 mLaliquots in 5 mL PETG vials and were subjected to five freeze-thawcycles. For each cycle, the vials were frozen at −70° C. and thawed toroom temperature. After each thaw, the contents of each vial were mixedby gently inverting approximately 5 times before being returned to −70°C. for the next cycle.

For agitation stress testing, samples were divided into 1.3 mL aliquotsin eight PETG vials. Four of the vials were agitated on an orbitalshaker (Thermo Scientific, Model #2309) at 220 RPM for 15 or 24 hours atambient temperature. In parallel, the remaining four vials were placedon the bench top near the shaker as stationary controls. At 15 and 24hours, two vials from the test group and two from the control group wereanalyzed.

Results

All of the samples were clear and colorless liquids (data not shown).

The pH of each sample is reported in FIG. 12. The pH of all samples wasmaintained within 0.1 pH units of the initial pH value.

The total protein content in each of samples is reported in FIG. 13.Protein content of all stressed samples was within 3 percent of totalprotein content in the unstressed sample at t=0.

In sum, the tested compositions comprising SapC and 25 mM Tris pH 7.1(actual pH was 7.1 at t=0; target pH was 7.2) exhibited stabilityfollowing exposure to mechanical or thermal stress as assessed by visualappearance, pH, and total protein content.

Example 5. Determination of How Various Concentrations of T-Butanol(TBA) Affect the Stability and Purity of Compositions Comprising SapCand Dioleoyl Phosphatidylserine (DOPS)

T-butanol (or t-butyl alcohol; TBA) was used as an organic solvent todissolve DOPS prior to incorporating DOPS into various SapCcompositions. To determine how various concentrations of TBA affectstability and purity of compositions comprising SapC, compositionscomprising the concentrations of TBA listed in Table 10 were prepared,filtered, and analyzed for visual appearance, total protein content, andDOPS content.

Methods

The compositions listed in Table 10 were prepared and assessed beforeand after standard sterile filtration through a 0.2 micron filter. Allpercentages are w/w. The visual appearance and total protein content ineach composition were assayed as described in Example 2. The total DOPScontent in each composition was assayed by HPLC in conjunction withevaporative light scattering detector (HPLC-ELSD).

TABLE 10 Compositions containing TBA UID Description 183-001-01-050-F12.3 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 9 percent trehalose, 30percent TBA, 50 mM Tris pH 7.2 183-001-01-050-F2 2.3 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 9 percent trehalose, 25 percent TBA, 50mM Tris pH 7.2 183-001-01-050-F3 2.3 mg/mL SapC, SapC:DOPS molar ratioof 1:12, 9 percent trehalose, 20 percent TBA, 50 mM Tris pH 7.2183-001-01-050-F4 2.3 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 9percent trehalose, 15 percent TBA, 50 mM Tris pH 7.2Results

The visual appearance of each sample is described in Table 10. All ofthe samples were clear and colorless liquids both before and afterfiltration.

TABLE 11 Visual appearance each sample before and after filtration UIDBefore filtration After filtration 183-001-01-050-F1 Clear, colorless,Clear, colorless, and particle free and particle free 183-001-01-050-F2Clear, colorless, Clear, colorless, and particle free and particle free183-001-01-050-F3 Clear, colorless, Clear, colorless, and particle freeand particle free 183-001-01-050-F4 Clear, colorless, Clear, colorless,and particle free and particle free

The total protein content of each sample is reported in Table 12. All ofthe samples exhibited no significant change in protein content beforeand after filtration.

TABLE 12 Total protein content (mg/mL) in each composition before andafter filtration UID Before filtration After filtration183-001-01-050-F1 2.25 2.3 183-001-01-050-F2 2.59 2.55 183-001-01-050-F32.21 2.26 183-001-01-050-F4 2.49 2.51

The total DOPS content in each sample is reported in Table 13. Thecompositions exhibited no significant change in DOPS content before andafter filtration.

TABLE 13 Total DOPS content (mg/mL) in each composition before and afterfiltration UID Before filtration After filtration 183-001-01-050-F1 3.063.10 183-001-01-050-F2 2.98 3.04 183-001-01-050-F3 2.97 2.97183-001-01-050-F4 3.00 2.94

In sum, these data indicate that samples comprising 15 to 35 percent TBAexhibited similar visual appearance, protein content, and DOPS contentbefore and after filtration.

Example 6. Determination of How Certain Excipients and Buffering AgentsAffect the Stability and Purity of Compositions Comprising SapC and DOPS

To determine how certain excipients and buffering agents affectstability and purity of compositions comprising SapC, the compositionslisted in Table 14 were prepared, and the stability and purity of eachcomposition was evaluated.

Methods

The compositions listed in Table 14 were prepared and 1.2 ml aliquotswere lyophilized according to the lyophilization procedure described inTable 15. Each lyophilized sample was then reconstituted with 1.2 mL ofHyClone™ purified water, and the lyophilized cakes were allowed todissolve completely.

The following properties were assayed as described in Example 2: visualappearance; total protein content, and purity of protein content. Themoisture content in each lyophilized sample was determined by acoulometric method. The percentage of TBA in each sample was determinedby a gas chromatography coupled to mass spectrometry (GC-MS) head spacemethod. (The TBA in the samples was what remained from the TBA used assolvent for DOPS, after sublimation of most of the TBA from the samplesduring the lyophilization process.)

In a further experiment, a sample of each reconstituted composition wasstored at 50° C. for either 2 or 5 weeks and its stability assessed byvisual appearance and purity of protein content analyzed as described inExample 2, by purity as measured using RP-HPLC, and by particle sizedistribution. The sizes of particles in each reconstituted liquid at t=0and t=5 weeks were determined by dynamic light scattering using aMalvern instrument.

TABLE 14 Compositions prepared for lyophilization and reconstitution UIDDescription 76114-F1 0.4 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25percent TBA, 9 percent sucrose, 10 mM Tris pH 8 76114-F2 0.4 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 25 percent TBA, 9 percent trehalose, 10mM Tris pH 8 76114-F3 0.4 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25percent TBA, 4 percent mannitol, 1 percent sucrose, 10 mM Tris pH 876114-F4 0.4 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 percent TBA,9 percent sucrose, 10 mM Tris pH 7.2 76114-F5 0.4 mg/mL SapC, SapC:DOPSmolar ratio of 1:12, 25 percent TBA, 9 percent trehalose, 10 mM Tris pH7.2 76114-F6 0.4 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 percentTBA, 4 percent mannitol, 1 percent sucrose, 10 mM Tris pH 7.2 76114-F70.4 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 percent TBA, 9 percentsucrose, 10 mM histidine pH 6.5 76114-F8 0.4 mg/mL SapC, SapC:DOPS molarratio of 1:12, 25 percent TBA, 8 percent trehalose, 10 mM histidine pH6.5 76114-F9 0.4 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 percentTBA, 4 percent mannitol, 1 percent sucrose, 10 mM histidine pH 6.5

TABLE 15 Lyophilization cycle used to prepare lyophilized compositionsPurpose Description Loading Hold at 5° C. Freezing Ramp at 0.3° C./minfor 183 min; Hold at −50° C. for 60 min; Ramp at 0.3° C./min for 133min; Hold at −10° C. for 120 min; Ramp at 0.3° C./min for 133 min; Hold−50° C. for 180 min Primary Hold −50° C. for 30 min at 50 mTorr; dryingRamp at 0.3° C./min for 67 min at 50 mTorr; Hold at −40° C. for 2400 minat 50 mTorr Secondary Ramp at 0.5° C./min for 120 min, 50 mTorr; dryingHold at 30° C. for 480 min at 50 mTorrResults

The visual appearance of each sample is summarized in Table 16. All ofthe samples containing 9 percent sucrose showed particles uponreconstitution at t=0, while all of the samples containing trehalosewere particle-free—an important consideration for an injectablecomposition.

TABLE 16 Visual appearance of lyophilized cake and of reconstitutedliquid at t = 0 UID Lyophilized cake Reconstituted liquid at t = 076114-F1 White fluffy, Cloudy, particles seen; some cracking particlespelleted upon centrifugation 76114-F2 White fluffy, Clear, colorless,particle free some cracking 76114-F3 White fluffy, Slightly cloudy,particle free some cracking 76114-F4 White fluffy, Cloudy, particlesseen; some cracking and particles pelleted shrinkage upon centrifugation76114-F5 White fluffy, Clear, colorless, particle free some cracking andshrinkage 76114-F6 White fluffy, Slightly cloudy, particle free somecracking 76114-F7 White fluffy, Cloudy, particles seen; some crackingand particles pelleted shrinkage upon centrifugation 76114-F8 Whitefluffy, Clear, colorless, particle free some cracking and shrinkage76114-F9 White fluffy, Clear, colorless, particle free some cracking

The total protein content of each reconstituted composition is reportedin Table 17.

TABLE 17 Total protein content (mg/mL) in each reconstituted compositionat t = 0, as assessed by RP-HPLC Percentage recovery Total protein ofSapC against UID content (mg/mL) theoretical 76114-F1 0.38 91 76114-F20.37 87 76114-F3 0.37 88 76114-F4 0.37 87 76114-F5 0.36 87 76114-F6 0.3789 76114-F7 0.36 86 76114-F8 0.36 85 76114-F9 0.38 91

The purity of SapC in each reconstituted composition at t=0 is reportedin Table 18.

TABLE 18 SapC purity in each composition as assessed by RP-HPLC andIEX-HPLC at t = 0 Percentage SapC Percentage SapC UID purity by RP-HPLCpurity by IEX-HPLC 76114-F1 93.2 96.1 76114-F2 93.2 95.9 76114-F3 93 9676114-F4 93.6 96 76114-F5 93.5 95.8 76114-F6 93.6 96 76114-F7 93.6 95.876114-F8 91.8 95.8 76114-F9 93.9 95.9

The percentage of TBA in each reconstituted composition is reported inTable 19. All reconstituted compositions comprising 9 percent sucrose(F1, F4, and F7) contained higher levels of residual TBA compared to theother compositions tested.

TABLE 19 Percent TBA in each reconstituted composition at t = 0 UIDPercent TBA 76114-F1 2.4 76114-F2 1.9 76114-F3 0.3 76114-F4 2.3 76114-F51.7 76114-F6 0.2 76114-F7 2.2 76114-F8 1.8 76114-F9 0.3

TABLE 20 Moisture content in each lyophilized composition UID Percentwater at t = 0 76114-F1 0.3 76114-F2 0.4 76114-F3 2.1 76114-F4 0.476114-F5 0.3 76114-F6 1.1 76114-F7 0.4 76114-F8 0.3 76114-F9 1.0

FIG. 14 is a graph depicting RP-HPLC measurements of SapC purity andpercent recovery in reconstituted compositions at t=0 and after storagefor 2 weeks at 50° C. The purity of SapC after 2 weeks at 50° C.remained greater than 90 percent in all samples buffered with histidineat pH 6.5 (76114-F7, -F8, and -F9), as well as in the 76114-F6 sample(buffered with Tris at pH 7.2). All other samples exhibited less than 85percent SapC purity after 2 weeks at 50° C.

The lyophilized material for samples comprising 9 percent sucrose(76114-F1, -F4, -F7) melted after 2 weeks at 50° C. (data not shown),while the other lyophilized samples did not exhibit significant changesin visual appearance after 2 weeks at 50° C.

FIG. 15 is a graph depicting results of dynamic light scattering forsample 76114-F5 at t=0 (A) and after 5 weeks (B) at 50° C. FIG. 16 is agraph depicting results of dynamic light scattering for sample 76114-F6at t=0 (A) and after 5 weeks (B) at 50° C. The compositions comprising 9percent trehalose (F2, F5, F8) showed the most uniform and reproducibleparticle size volume distribution by dynamic light scattering comparedto all other compositions tested.

In sum, these data suggest that trehalose is the preferred sugarexcipient, compared to sucrose and to a mixture of mannitol and sucrose.This is despite the fact that compositions with mannitol/sucrosemixtures exhibited the lowest percentage TBA of all compositions tested.Additionally, these data indicate that compositions comprising SapC andDOPS are more stable in 10 mM Tris at pH 6.5 or pH 7.2 compared to in 10mM Tris at pH 8.

Example 7: Determination of How Select Concentrations of SapC and DOPS(at a Constant SapC to DOPS Molar Ratio) Affect the Stability and Purityof Compositions Comprising SapC and DOPS

To determine how various concentrations of SapC and DOPS affectstability and purity of the compositions, the compositions listed inTable 21 were prepared, and the stability and purity of each compositionwere evaluated.

Methods

The compositions listed in Table 21 were prepared and 1.2 ml aliquotslyophilized according to the lyophilization method described in Example6. Each lyophilized sample was then reconstituted with 1.2 mL ofHyClone™ water, and the lyophilized cakes were allowed to completelydissolve. The sizes of particles in each reconstituted sample at t=0were determined by dynamic light scattering using a Malvern instrument.

TABLE 21 Compositions pre-lyophilization UID Description 76733-F1 4.2mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 percent TBA, 10 mg/mLtrehalose, 25 mM phosphate pH 7.4 76733-F2 2.2 mg/mL SapC, SapC:DOPSmolar ratio of 1:12, 25 percent TBA, 10 mg/mL trehalose, 25 mM phosphatepH 7.4 76733-F3 1.3 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25percent TBA, 10 mg/mL trehalose, 25 mM phosphate pH 7.4 76733-F4 0.82mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 percent TBA, 10 mg/mLtrehalose, 25 mM phosphate pH 7.4 76733-F5 0.42 mg/mL SapC, SapC:DOPSmolar ratio of 1:12, 25 percent TBA, 10 mg/mL trehalose, 25 mM phosphatepH 7.4Results

FIG. 17 is a graph depicting results of dynamic light scattering foreach reconstituted sample at t=0. FIG. 18 is a graph depicting change indynamic light scattering for each reconstituted sample over time. Thecomposition with the highest concentration of SapC, 4.2 mg/mL, showedhigher average particle size relative to compositions with 2.2 mg/mL orlower concentrations of SapC. All reconstituted compositions maintainedconsistent average particle size over the 4 hour period, suggesting astable reconstituted product. These results suggest that the preferredconcentration of SapC is less than or equal to 2.2 mg/mL SapC, at a SapCto DOPS molar ratio of 1:12.

Example 8: Determination of How Various Concentrations of Mannitol andTrehalose Affect the Stability of Compositions Comprising DOPS

To determine how various concentrations of mannitol and trehalose affectstability and purity of compositions comprising DOPS, the compositionsdescribed in Tables 22 and 23 were prepared, lyophilized, andreconstituted in water.

Methods

The compositions listed in Table 22 were prepared and 0.8 ml aliquots in2 ml vials or 4 ml aliquots in 10 ml vials were lyophilized according tothe lyophilization process described in Example 6. Each vial oflyophilized sample was reconstituted with HyClone™ water; thelyophilized cakes were allowed to completely dissolve. The visualappearance of the lyophilized cakes and the percentage of TBA in eachreconstituted sample were assayed as described in Example 6.

TABLE 22 Pre-lyophilization compositions UID Description 81494-F1 1.6mg/mL DOPS, 10 mM histidine pH 6, 1.5 percent mannitol 81494-F2 1.6mg/mL DOPS, 10 mM histidine pH 6, 0.3 percent trehalose 81494-F3 1.6mg/mL DOPS, 10 mM histidine pH 6, 0.9 percent mannitol 81494-F4 1.6mg/mL DOPS, 10 mM histidine pH 6, 1.5 percent trehalose 81494-F5 1.6mg/mL DOPS, 10 mM histidine pH 6, 5 percent mannitol 81494-F6 1.6 mg/mLDOPS, 10 mM histidine pH 6, 4 percent mannitol, 1 percent trehalose81494-F7 1.6 mg/mL DOPS, 10 mM histidine pH 6, 3 percent mannitol, 2percent trehalose 81494-F8 1.6 mg/mL DOPS, 10 mM histidine pH 6, 5percent trehalose 81494-F9 1.6 mg/mL DOPS, 10 mM histidine pH 6, 9percent mannitol 81494-F10 1.6 mg/mL DOPS, 10 mM histidine pH 6, 7.2percent mannitol, 1.8 percent trehalose 81494-F11 1.6 mg/mL DOPS, 10 mMhistidine pH 6, 5.4 percent mannitol, 3.6 percent trehalose 81494-F121.6 mg/mL DOPS, 10 mM histidine pH 6, 9 percent trehalose

The compositions listed in Table 23 were prepared and lyophilizedaccording to the lyophilization process described in Example 6, with onemodification: primary drying temperature hold at −45° C. instead of holdat −40° C. Each lyophilized sample was reconstituted with 1.2 mL ofHyClone™ water; the lyophilized cakes were allowed to completelydissolve. The following properties were assayed as described in Example6: visual appearance of lyophilized cakes, percentage TBA in eachreconstituted sample, and particle size distribution in eachreconstituted sample.

TABLE 23 Pre-lyophilization compositions used in modified lyophilizationprocess UID Description 183-001-01-114-F1 2.2 mg/mL SapC, 2.4 mg/mLDOPS, 10 mM citrate pH 6.2, 4 percent mannitol, 1 percent trehalose183-001-01-114-F2 2.2 mg/mL SapC, 2.4 mg/mL DOPS, 10 mM citrate pH 6.2,3.5 percent mannitol, 1.5 percent trehalose 183-001-01-114-F3 2.2 mg/mLSapC, 2.4 mg/mL DOPS, 10 mM citrate pH 6.2, 2 percent trehalose183-001-01-114-F4 2.2 mg/mL SapC, 2.4 mg/mL DOPS, 10 mM citrate pH 6.2,7.2 percent mannitol, 1.8 percent trehalose 183-001-01-114-F5 2.2 mg/mLSapC, 2.4 mg/mL DOPS, 10 mM citrate pH 6.2, 6.3 percent mannitol, 2.7percent trehalose 183-001-01-114-F6 2.2 mg/mL SapC, 2.4 mg/mL DOPS, 10mM citrate pH 6.2, 5.4 percent mannitol, 3.6 percent trehaloseResults

Tables 24 and 25 includes qualitative observations of the lyophilizedcompositions, including whether or not cake formed and if cake formed,the integrity and quality of the cake.

TABLE 24 Appearance of lyophilized cake from Table 22 compositions UIDObservations 81494-F1 No cake formed 81494-F2 No cake formed 81494-F3 Nocake formed 81494-F4 No cake formed 81494-F5 No cake formed 81494-F6 Nocake formed 81494-F7 Compact, fluffy cake with no cracks 81494-F8Compact, fluffy cake with no cracks 81494-F9 Compact, fluffy cake withno cracks 81494-F10 Compact, fluffy cake with no cracks 81494-F11Compact, fluffy cake with no cracks 81494-F12 Compact, fluffy cake withsome shrinkage

TABLE 25 Appearance of lyophilized cake from Table 23 compositions UIDObservations 183-001-01-114-F1 4 of 4 vials exhibited compact, fluffycake with no cracks 183-001-01-114-F2 4 of 4 vials exhibited compact,fluffy cake with no cracks 183-001-01-114-F3 2 of 4 vials exhibitedcompact, fluffy cake with no cracks 183-001-01-114-F4 4 of 4 vialsexhibited compact, fluffy cake with no cracks 183-001-01-114-F5 3 of 4vials exhibited compact, fluffy cake with no cracks 183-001-01-114-F6 4of 4 vials exhibited compact, fluffy cake with no cracks

FIG. 19 is a graph depicting TBA percentage in each reconstituted sampleof the Table 22 compositions.

FIG. 20 is a graph depicting TBA percentage in each reconstituted sampleof the Table 23 compositions.

FIG. 21 is a graph showing particle size distributions for threereplicates of reconstituted liquids for the Table 23 compositions. PanelA shows data for 183-001-01-114-F1; panel B shows data for183-001-01-114-F4; panel C shows data for 183-001-01-114-F5; and panel Dshows data for 183-001-01-114-F6. A subset of the Table 22 compositions,namely 81494-F7, -F8, -F9, -F10, -F11, and -F12, formed high qualitylyophilized cakes. When reconstituted in water, all six of thosecompositions contained less than 3 percent TBA. The reconstituted81494-F9 and 81494-F10 compositions contained the lowest percent of TBA,at less than 0.5 percent. These data indicate that the constituents ofthe 81494-F7, F8, F9, F10, and F11 compositions may confer beneficialproperties on both the lyophilized cake and reconstituted solution.

The quality and integrity of lyophilized cake was high for allcompositions prepared with the modified lyophilization process (theTable 23 compositions), and all of those compositions, whenreconstituted, had TBA levels below 0.5 percent. These results confirmprevious experiments which showed that a higher percentage of mannitolcorrelated with a lower level of TBA in reconstituted compositions.However, compositions comprising mannitol do not exhibit as uniform andreproducible particle size distribution as has been observed forcompositions comprising trehalose as the sole sugar excipient.Therefore, trehalose is the preferred sugar excipient for compositionscomprising SapC and DOPS.

Example 9. Determination of How Various Compositions Affect theStability and Purity of Compositions Comprising SapC and DOPS

Based on results of previous Examples, a preferred composition for aSapC-DOPS pharmaceutical product was determined to be 2.2 mg/mL SapC,2.4 mg/mL DOPS (SapC:DOPS molar ratio of 1:12), 25 mM Tris pH 7.2, 5percent trehalose. To determine how varying the pH and concentrations ofthe components affect stability and purity of compositions comprisingSapC and DOPS, the compositions listed in Table 26 were prepared andevaluated.

Method

The compositions listed in Table 26 were prepared. 4 ml aliquots wereplaced in vials and lyophilized according to lyophilization processdescribed in Example 6, with one modification: the secondary drying timewas 25 hours instead of 15 hours. The lyophilized cakes were stored at50° C. for 4 weeks (or stored at 25° C. for 2 or 4 weeks) beforeanalysis and reconstitution with 1.2 mL of HyClone™ water. The followingproperties were assayed as described in Example 2: visual appearance,pH, total protein content, and purity of protein content in thereconstituted samples. The following properties were assayed asdescribed in Example 6: visual appearance of lyophilized cakes,percentage TBA in the reconstituted samples, and particle sizedistribution in each reconstituted sample.

TABLE 26 Compositions, pre-lyophilization UID Description183-001-01-141-F1 2.2 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 mMTris pH 7.2, 5 percent trehalose 183-001-01-141-F2 3.4 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 25 mM Tris pH 6.8, 7.5 percent trehalose183-001-01-141-F3 1.0 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 mMTris pH 7.6, 7.5 percent trehalose 183-001-01-141-F4 3.4 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 25 mM Tris pH 7.6, 2.5 percent trehalose183-001-01-141-F5 1.0 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 mMTris pH 6.8, 2.5 percent trehalose 183-001-01-141-F6 2.2 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 25 mM Tris pH 7.2, 5 percent trehalose183-001-01-141-F7 2.2 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 mMTris pH 7.2, 5 percent trehalose 183-001-01-141-F8 3.4 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 25 mM Tris pH 7.6, 7.5 percent trehalose183-001-01-141-F9 1.0 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 mMTris pH 7.2, 2.5 percent trehalose 183-001-01-141-F10 3.4 mg/mL SapC,SapC:DOPS molar ratio of 1:12, 25 mM Tris pH 6.8, 2.5 percent trehalose183-001-01-141-F11 1.0 mg/mL SapC, SapC:DOPS molar ratio of 1:12, 25 mMTris pH 6.8, 7.5 percent trehaloseResults

Table 27 includes qualitative observations of the lyophilizedcompositions stored at 50° C. for 4 weeks and of reconstitutedcompositions prepared from the stored lyophilized compositions and thenanalyzed immediately. The pH of each reconstituted sample is reported inTable 28, and the percentage TBA is shown in Table 29.

TABLE 27 Appearance of lyophilized cake stored at 50° C. for 4 weeks andappearance of reconstituted liquid prepared from the stored cake Recon-stituted UID Lyophilized cake solution 183-001-01-141-F1 Compact, fluffycake with no cracks Slightly cloudy 183-001-01-141-F2 Compact, fluffycake with no cracks Slightly cloudy 183-001-01-141-F3 Compact, fluffycake with no cracks Clear 183-001-01-141-F4 Compact, fluffy cake with nocracks Cloudy 183-001-01-141-F5 Compact, fluffy cake with no cracksSlightly cloudy 183-001-01-141-F6 Compact, fluffy cake with no cracksSlightly cloudy 183-001-01-141-F7 Compact, fluffy cake with no cracksSlightly cloudy 183-001-01-141-F8 Compact, fluffy cake with no cracksSlightly cloudy 183-001-01-141-F9 Compact, fluffy cake with no cracksSlightly cloudy 183-001-01-141-F10 Compact, fluffy cake with no cracksCloudy 183-001-01-141-F11 Compact, fluffy cake with no cracks Clear

TABLE 28 pH of each reconstituted composition prepared after storing thelyophilized samples for 4 weeks UID pH 183-001-01-141-F1 7.2183-001-01-141-F2 6.8 183-001-01-141-F3 7.6 183-001-01-141-F4 7.6183-001-01-141-F5 6.8 183-001-01-141-F6 7.2 183-001-01-141-F7 7.2183-001-01-141-F8 7.6 183-001-01-141-F9 7.6 183-001-01-141-F10 6.8183-001-01-141-F11 6.8

TABLE 29 Percentage TBA in each reconstituted composition prepared afterstoring the lyophilized samples for 4 weeks UID Percentage TBA183-001-01-141-F1 1.85 183-001-01-141-F2 1.94 183-001-01-141-F3 1.81183-001-01-141-F4 1.58 183-001-01-141-F5 1.62 183-001-01-141-F6 1.78183-001-01-141-F7 1.74 183-001-01-141-F8 1.92 183-001-01-141-F9 1.38183-001-01-141-F10 1.44 183-001-01-141-F11 1.79

FIG. 22 is a graph depicting RP-HPLC measurements of SapC purity in eachreconstituted composition prepared from lyophilized powder that had beenstored at 25° C. for 2 or 4 weeks.

FIG. 23 is a graph depicting IEX-HPLC measurements of SapC purity ineach reconstituted composition prepared from lyophilized powder that hadbeen stored at 25° C. for 2 or 4 weeks.

FIG. 24 is a graph depicting average particle size over time in eachreconstituted composition prepared from lyophilized powder that had beenstored at 25° C. for 2 or 4 weeks.

The above data regarding the Table 26 compositions indicate:

-   (1) lyophilized cakes of all compositions reconstituted almost    immediately upon addition of the diluent;-   (2) appearance of all lyophilized compositions remained unchanged    after 4 weeks storage at 50° C.;-   (3) appearance of reconstituted products showed a composition    containing 2.2 mg/mL SapC, DOPS in an amount yielding a SapC:DOPS    molar ratio of 1:12, 25 mM Tris pH 7.2, and 5 percent trehalose (the    preferred composition) to have acceptably low haziness;-   (4) pH remained stable in all reconstituted compositions held at    50° C. for 2 or 4 weeks;-   (5) reconstituted compositions with lower percentage trehalose had    lower percentage TBA;-   (6) average residual TBA of the preferred composition (n=3; F1, F6    and F7) after reconstitution was 1.8 percent;-   (7) compositions with higher percentage trehalose exhibited lower    average particle size and compositions.

Based on all data from Examples 1-9, a composition comprising a molarratio of phosphatidylserine lipid to polypeptide in the range of 8:1 to20:1, Tris buffer, trehalose, and TBA provided the preferred physicaland chemical properties of a clinical composition.

Example 10. Evaluation of Activity of Compositions Comprising SapC andDOPS

Saposin C, in the presence of an anionic phospholipid (DOPS), is knownto activate the enzyme glucocerebrosidase (GBA) to catalyze thehydrolysis of cerebroside into ceremide and glucose. To test thisfunction of the SapC-DOPS compound in vitro, recombinant human GBAenzyme (R&D Systems, cat #:7410-GHB-020) is used and, in lieu ofcerebroside, 4-methylumbelliferyl-β-D-glucopyranoside, or 4-MUG, (Sigma,cat #:M3633) is used as the substrate. SapC-DOPS will activate rhGBA tocleave 4-MUG into 4-methylumbellierone (4-MU), which gives off afluorescent signal, and glucose.

In the example below, the positive control sample was found to have 102%relative potency of the reference (REF) standard. Of note, a passingresult of this assay is 70-160% relative potency. A specificity (SPEC)sample was also tested to show decreased activity if the SapC is damagedin some way. The SPEC sample contained SapC treated at 70° C. for 48hours, then compounded with DOPS. Relative potency was unable to bedetermined for the SPEC sample because the curves are deemed to bedifferent. However, the top of the best-fit curve of the SPEC sample was79% of the top of the best-fit curve of the REF sample. A passing resultfor specificity is <90%. In addition, controls were utilized thatinclude different combinations of some but not all of the criticalcomponents of the assay. Notable among these are: enzyme plus substratewithout SapC-DOPS (GBA+4MU), enzyme plus substrate plus DOPS, withoutSapC (DOPS only), and enzyme plus substrate plus SapC without DOPS (SapConly). None of these controls produced a significant fluorescent signal,showing that both SapC and DOPS are needed to activate the enzyme tocleave the substrate.

FIG. 25 is a graph showing results of a GBA enzyme assay testingactivity of SapC-DOPS.

Example 11. Protocol for Treatment with a Pharmaceutical CompositionComprising SapC and DOPS

Patients 18 years of age or older with advanced solid tumors orrecurrent high-grade gliomas (HGG) were enrolled in a Phase 1,open-label, dose-escalation clinical trial of a SapC/DOPS compositiondesignated BXQ-350. The lyophilized BXQ-350 product (supplied as alyophilized powder in a vial) is reconstituted with sterile water forinjection to produce an aqueous solution containing human SapC at 2.2mg/ml (+/−0.3 mg/ml); the sodium salt of DOPS at 2.4 mg/ml (+/−0.4mg/ml); Tris at 25 mM (+/−2 mM), pH 7.2 (+/−0.4); trehalose at 5 percentw/v (+/−1 percent). If t-butyl alcohol is present, it is at less than 2percent w/w.

Following a dose-escalation study, a BXQ-350 dose that delivers 2.4 mgof SapC per kg body weight was selected for further study. Theadministration protocol includes at least one cycle of treatment.Treatment may continue through six cycles of treatment or until diseaseprogression, as described, for example, in Table 30. BXQ-350 is suppliedas a lyophilized powder in glass vials. Prior to administration, thesolid drug product is reconstituted in the vials by adding to the vial 4mL sterile water for injection, USP, resulting in a reconstituted drugstrength of 2.2 mg/mL of SapC in the vial. The reconstituted drugproduct is then diluted to the target IV administration concentration insterile 0.9% saline in IV bags. Each dose is administered by IV infusionover a time period of approximately 45 minutes±15 minutes.

TABLE 30 Administration Schedule Administration Schedule of BXQ-350Cycle 1 - Cycle 1 - Week 1 Cycle 1 - Week 2 Weeks 3 & 4 Cycles 2-6 Days1-5 Days 8, 10, & 12 Days 15 & 22 Days 29, 57, 85, (5 consecutive (Everyother day) (Once every 113, & 141 days) 7 ± 3 days) (Once every 28 ± 3days)

FIG. 26 is a table showing Phase 1a demographics and adverse events bydosing group. No treatment-related serious adverse events were reported.

Preclinical PK/TK was allometrically scaled to predict human PK andexposure (Area Under Curve (AUC)) at 0.7-2.4 mg/kg therapeutic doses.Human clearance, terminal volume of distribution (Vz), half-life, andAUC (at 0.7-2.4 mg/kg doses) from the First In Human (FIH) trial aresummarized as follows: clearance (Cl) 57-76 mL/kg/hr, Vz 314-509 mL/kg,and half-life 3.5-5 hr. The corresponding AUCs ranged from 10,020 to42,330 hr*ng/mL. Efficacy typically occurred in murine models at dosesof 4-16 mg/kg and corresponding AUCs of 7,400-29,600 hr*ng/mL. Based onmouse data, the FIH exposures fall within desired exposure range. FIGS.27A-C are three sets of graphs illustrating the pharmacokinetic resultson Day 1 (FIG. 27A), Day 4 (FIG. 27B), and Day 22 (FIG. 27C) of thePhase 1 trial. Data are presented as a semi-log plot (top of each set).Pharmacokinetics were dose-proportional.

FIG. 29 is a swimmer plot illustrating patient outcomes in the Phase 1atrial. Some of the individual subjects are discussed below in Examples12-14.

Example 12. Use of Pharmaceutical Composition Comprising SapC and DOPSto Treat a Patient Diagnosed with Parietal Anaplastic Ependymoma

Methods

Ependymomas are rare primary nervous system tumors accounting for about3% of adult brain tumors in the US. Standard of care includes maximalsurgical resection and radiation therapy. There is no FDA-approved drugtherapy.

A 67-year old white male with a history of prostate cancer was diagnosedin October 2014 with a left parietal anaplastic ependymoma. He underwenta gross total resection, followed by adjuvant radiation. Repeat brainMRI in April 2017 showed a local recurrence. He received 3 cycles oftemolozomide with no response. He was enrolled in the BXQ-350 trial inSeptember 2017; at the time of enrollment, his Eastern CooperativeOncology Group (ECOG) performance status was 1, and his main symptomswere aphasia and right sided-weakness. The patient received cycle 1(BXQ-350 2.4 mg/kg IV infusion at Day 1-5, 8, 10, 12, 15, 22) and 3additional cycles (1×28 days), and was followed until death for safety,response, Revised Assessment in Neuro-Oncology (RANO), and ECOGperformance status.

Results

At baseline, the temporal lesion was 6.4×3.2 cm, associated with skulland scalp invasion. After 2 cycles, minor decrease in size ofintracranial enhancing components was reported (overall stable diseaseper RANO). The patient received 4 total cycles of BXQ-350 withoutrelated adverse events or toxicities. Cycle 5 was withheld due to volumeprogression on Mill. He died 6 months post-enrollment, due to the braintumor mass effect. Post-mortem histology and gross anatomy showedextensive brain tumor necrosis with chondroid differentiation and signsof necrotic disease in thoracic and lumbar spine on microscopy. Thebrain tumor necrosis observed at autopsy appeared to betreatment-related and are an indication that the drug was toxic to thetumor cells.

FIGS. 28A-D depict results from post-mortem histology and gross anatomyanalysis; from left to right: (A) The initial surgical specimen showedlittle evidence of ependymal differentiation and abundant mitoticfigures. H&E at 40×; (B) Gross brain examination at autopsy showedextensive tumor necrosis; (C) Microscopic examination of sections oftumor shows necrosis and little viable tumor (H&E at 4× with insert at40×); (D) At autopsy there was extensive chondroid differentiation atthe site where tumor extended through the surgical defect and scalp.

Example 13. Use of a Pharmaceutical Composition Comprising SapC and DOPSto Treat Patients Diagnosed with High-Grade Glioma

Nine adult patients with high-grade glioma (HGG) were included in adose-escalation trial intended to study safety of BXQ-350. The doses,given in cycles in accordance with the Table 30 protocol, ranged from0.7 mg/kg to 2.4 mg/kg. Eight of the nine HGG patients completed a fullset of cycles before withdrawal (seven due to progression; one voluntarywithdrawal).

One patient with GBM completing more than six cycles (>12 months) oftreatment with doses starting at 0.7 mg/kg exhibited stable disease, adecrease in lesion size, and no significant progressive functionalneurological deficits. Six of the HGG patients had improved RANO/RECISTat day 113.

Example 14. Use of a Pharmaceutical Composition Comprising SapC and DOPSto Treat a Patient Diagnosed with Adenocarcinoma of the Appendix

A 62-yr old female with locally advanced mucinous adenocarcinoma of theappendix was treated as part of the Phase 1a trial. Following resectionand post-operative adjuvant chemotherapy (FOLFOX), a 2007 recurrence inthe pelvis involving ovaries led to debulking surgery including totalabdominal hysterectomy/bilateral salpingo-oopherectomy followed bysystemic therapy with irinotecan and cetuximab. In 2009, recurrence ledto extensive debulking surgery and intraabdominal hyperthermicperfusion, with complete remission. After declining treatment forrecurrence in 2016, she started BXQ-350 in July 2017. She was given 2.4mg/kg BXQ-350 by IV, in accordance with the phase 1 protocol andexperienced a partial response, remaining on study in the Phase 1b trialafter completing 11 cycles and without serious adverse eventsattributable to BXQ-350.

Example 15. Use of a Pharmaceutical Composition Comprising SapC and DOPSto Treat Patients Diagnosed with Rectal Adenocarcinoma

Adult patients with various solid tumors were included in adose-escalation trial intended to study safety of BXQ-350. The doses,given in cycles in accordance with the Table 30 protocol, ranged from0.7 mg/kg to 2.4 mg/kg. All patients completed at least one cycle beforewithdrawal.

One patient diagnosed with metastatic (Stave IV) rectal adenocarcinomacompleted more than 12 months of treatment with doses starting at 1.8mg/kg and exhibited stable disease, with evidence for significantdecrease of tumor metabolic activity by positron emission tomography(PET), utilizing flurodeoxyglucose (F-18 FDG) after more than 12 monthsof treatment. See FIGS. 30A and 30B.

What is claimed is:
 1. A composition comprising: a polypeptide comprising the amino acid sequence of SEQ ID NO: 1 with zero to four amino acid insertions, substitutions, or deletions; a phosphatidylserine lipid; a buffer at pH 5.0 to 8.0; trehalose at 1.5 to 9 percent w/w; t-butyl alcohol at 0 to 35 percent; and water, wherein the polypeptide is at a concentration of 0.4 to 5.0 mg/ml, and the molar ratio of the phosphatidylserine lipid to the polypeptide is in the range of 8:1 to 20:1.
 2. The composition of claim 1, wherein the buffer is tris(hydroxymethyl)aminomethane (Tris) at a concentration of 10 to 50 mM, and the pH of the composition is pH 6.8 to 7.6.
 3. The composition of claim 1, wherein the buffer is citrate buffer at a concentration of 10 to 50 mM.
 4. The composition of claim 1, wherein the buffer is acetate buffer at a concentration of 10 to 50 mM.
 5. The composition of claim 1, wherein the phosphatidylserine lipid is dioleoyl phosphatidylserine (DOPS).
 6. The composition of claim 1, wherein the phosphatidylserine lipid comprises one or more of DOPS, dihexanoyl phosphatidylserine lipid, dioctanoyl phosphatidylserine lipid, didecanoyl phosphatidylserine lipid, dilauroyl phosphatidylserine lipid, dimyristoyl phosphatidylserine lipid, dipalmitoyl phosphatidylserine lipid, palmitoyl-oleoyl phosphatidylserine lipid, 1-stearoyl-2-oleoyl phosphatidylserine lipid, or diphytanoyl phosphatidylserine lipid.
 7. The composition of claim 1, wherein the polypeptide's amino acid sequence comprises SEQ ID NO: 1 with one or two amino acid insertions, substitutions, or deletions.
 8. The composition of claim 1, wherein the polypeptide's amino acid sequence comprises SEQ ID NO:
 1. 9. The composition of claim 1, wherein the polypeptide's amino acid sequence consists of SEQ ID NO:
 1. 10. The composition of claim 1, wherein the polypeptide comprises the sequence of SEQ ID NO: 1 and is at a concentration of 1.9 to 2.5 mg/ml; the phosphatidylserine lipid is DOPS and is at a concentration of 2.0 to 2.8 mg/ml; the buffer is Tris at a concentration of 23 to 27 mM; the trehalose is at a concentration of 4 to 6 percent w/w; the pH of the composition is in the range of pH 6.8 to 7.6; and the composition further comprises t-butyl alcohol at a concentration of about 15 to 25 percent w/w.
 11. A composition in solid form comprising: a polypeptide comprising the amino acid sequence of SEQ ID NO: 1 with zero to four amino acid insertions, substitutions, or deletions; a phosphatidylserine lipid; a buffer; and trehalose at 75 to 90 percent w/w, wherein the polypeptide is at a concentration of 3.2 to 4.4 percent w/w, and the molar ratio of phosphatidylserine lipid to polypeptide is in the range of 8:1 to 20:1.
 12. The composition of claim 11, wherein the buffer is Tris at 5.6 to 7.6 percent w/w.
 13. The composition of claim 11, wherein the buffer is citrate buffer at 9 to 13 percent w/w.
 14. The composition of claim 11, wherein the buffer is acetate buffer at 3 to 5 percent w/w.
 15. The composition of claim 11, wherein the phosphatidylserine lipid is DOPS.
 16. The composition of claim 11, wherein the phosphatidylserine lipid comprises one or more of DOPS, dihexanoyl phosphatidylserine lipid, dioctanoyl phosphatidylserine lipid, didecanoyl phosphatidylserine lipid, dilauroyl phosphatidylserine lipid, dimyristoyl phosphatidylserine lipid, dipalmitoyl phosphatidylserine lipid, palmitoyl-oleoyl phosphatidylserine lipid, 1-stearoyl-2-oleoyl phosphatidylserine lipid, or diphytanoyl phosphatidylserine lipid.
 17. The composition of claim 11, wherein the polypeptide's amino acid sequence comprises SEQ ID NO: 1 with one or two amino acid insertions, substitutions, or deletions.
 18. The composition of claim 11, wherein the polypeptide's amino acid sequence comprises SEQ ID NO:
 1. 19. The composition of claim 11, wherein the polypeptide's amino acid sequence consists of SEQ ID NO:
 1. 20. The composition of claim 11, further comprising t-butyl alcohol in an amount less than 3 percent w/w.
 21. The composition of claim 11, wherein the polypeptide comprises the sequence of SEQ ID NO: 1 and is at a concentration of 3.3 to 4.3 percent w/w; the phosphatidylserine lipid is DOPS and is at a concentration of 3.4 to 4.8 percent w/w; the buffer is Tris and is at a concentration of 6.0 to 7.2 percent w/w; the trehalose is at a concentration of 81 to 87.3 percent w/w; and the composition further comprises t-butyl alcohol at a concentration of less than 3 percent w/w.
 22. A pharmaceutical composition comprising: a polypeptide comprising the amino acid sequence of SEQ ID NO: 1 with zero to four amino acid insertions, substitutions, or deletions; a phosphatidylserine lipid; a buffer at pH 5.0 to 8; trehalose at 1.5 to 9 percent w/v; and water, wherein the polypeptide is at a concentration of 0.4 to 5 mg/ml, and the molar ratio of phosphatidylserine lipid to polypeptide is in the range of 8:1 to 20:1.
 23. The pharmaceutical composition of claim 22, wherein the buffer is Tris at a concentration of 10 to 50 mM, and the pH of the composition is pH 6.8 to 7.6.
 24. The pharmaceutical composition of claim 22, wherein the buffer is citrate buffer at a concentration of 10 to 50 mM.
 25. The pharmaceutical composition of claim 22, wherein the buffer is acetate buffer at a concentration of 10 to 50 mM.
 26. The pharmaceutical composition of claim 22, wherein the phosphatidylserine lipid is DOPS.
 27. The pharmaceutical composition of claim 22, wherein the phosphatidylserine lipid comprises one or more of DOPS, dihexanoyl phosphatidylserine lipid, dioctanoyl phosphatidylserine lipid, didecanoyl phosphatidylserine lipid, dilauroyl phosphatidylserine lipid, dimyristoyl phosphatidylserine lipid, dipalmitoyl phosphatidylserine lipid, palmitoyl-oleoyl phosphatidylserine lipid, 1-stearoyl-2-oleoyl phosphatidylserine lipid, or diphytanoyl phosphatidylserine lipid.
 28. The pharmaceutical composition of claim 22, wherein the polypeptide's amino acid sequence comprises SEQ ID NO: 1 with one or two amino acid insertions, substitutions, or deletions.
 29. The pharmaceutical composition of claim 22, wherein the polypeptide's amino acid sequence comprises SEQ ID NO:
 1. 30. The pharmaceutical composition of claim 22, wherein the polypeptide's amino acid sequence consists of SEQ ID NO:
 1. 31. The pharmaceutical composition of claim 22, further comprising t-butyl alcohol in an amount less than 3 percent.
 32. The pharmaceutical composition of claim 22, wherein the polypeptide comprises the amino acid sequence of SEQ ID NO: 1 and is at a concentration of 1.9 to 2.5 mg/ml; the phosphatidylserine lipid is DOPS and is at a concentration of 2.0 to 2.8 mg/ml; the buffer is Tris and is at a concentration of 23 to 27 mM; the trehalose is at a concentration of 4 to 6 percent w/w; the pH of the composition is in the range of pH 6.8 to 7.6; and the composition further comprises t-butyl alcohol in an amount less than 0.5 percent w/w.
 33. A method of treating cancer in a human patient, the method comprising administering the composition of claim 22 to the patient.
 34. The method of claim 33, wherein the patient has a solid tumor.
 35. The method of claim 34, wherein the patient has a glioma or ependymoma.
 36. The method of claim 34, wherein the patient has a gastrointestinal cancer.
 37. The method of claim 33, wherein the composition is delivered intravenously in a dose ranging from 0.4 mg/kg to 7 mg/kg SapC, and the ratio of SapC to DOPS in the composition is in the range of 1:8 to 1:20.
 38. The method of claim 33, wherein the composition is delivered intravenously in a dose of 2.3-2.5 mg/kg SapC, and the ratio of SapC to DOPS in the composition is in the range of 1:11 to 1:13.
 39. The method of claim 37, wherein the composition is administered repeatedly to the patient over at least two cycles, as follows: Cycle 1: week 1: one dose on each of days 1-5; week 2: three doses every other day; weeks 3 and 4: one dose each week (every 7 (+/−3) days); Cycle 2: one dose during week
 5. 40. The method of claim 39, further comprising at least one subsequent cycle, wherein the at least one subsequent cycle comprises: one dose 28 (+/−3) days after the most recent prior dose.
 41. A method of treating cancer in a human patient, the method comprising reconstituting the composition of claim 11 in water or saline to produce a reconstituted composition, and intravenously administering a dose of the reconstituted composition to the patient. 